7 CEDARCREST ROAD - ABANDONMENT OF SUBSURFACE DISPOSAL SYSTEM-AUGUST, 2026 Ig
CITY OF SALEM, MASSACHUSETTS 10
o
BOARD OF HEALTH
98 WASHINGTON STREET,3RD FLOOR Public Health
SALEM,MA 01970 Prevent.Promote.Protect.
DOMINICK PANGALLO TEL. (978) 741-1800
MAYOR healthalsalem.com DAVID GREENBAUM,RS,CHO
HEALTH AGENT
Application for Abandonment of Subsurface
Disposal S%stem
Fee: $50.00
i
herewith apply for a permit to abandon the
Sub-surface sewage disposal system located at -:2 �'
Name of licensed drain layer: CZ
Phone Number:
If tank needs emptying, name of septage hauler: e v r c,
(Septage hauler must be licensed by the Salem Board of Health, copy dt the Pumping record has to be provided
at time of abandonment)
Date: � Z Z r,
Signed:
(owner plicant)
FOR OFFICIAL USE ONLY
By:Amount received: ,.�
2Q�
Date abandoned: Witnessed by:
CITY OF SALEM MLASSACHUSETTS 10
BOARD OF HEALTH
98 W ASHINGTON STREET,3A"FLOOR PublicHealth
S ALEM,MA 01970 Prevent.Promote.Protect.
TEL. (978) 741-1800
DOMINICK PANGALLO health&salem.com DAVID GRE'ENBAUM,RS,CHO
MAYOR HEAL'rII AGENT
August 27, 2026
To whom it may concern:
RE: 7 Cedarcrest Road, Salem MA 01970
Please be advised that the onsite wastewater disposal system located at 7 Cedarcrest Road, Salem MA, 01970 has
been abandoned and the house was connected to City Sewer as of August 19,2026
Please feel free to contact us if we can provide further information
Sin ere y,
avi Green n, tS, CHO
Health Agent
Cc: File
Building Inspector
City Engineer